Observations on certain dropsical affections which are successfully treated by blood-letting / by J. Abercrombie.

Date:
[1818]
Catalogue details

Licence: Public Domain Mark

Credit: Observations on certain dropsical affections which are successfully treated by blood-letting / by J. Abercrombie. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    having taken place at the next period, all these complaints were removed. * Similar symptoms are described in connection with suppression of the haemorrhoidal discharge, after it has become habitual, as in the case of the Emperor I rajan, which is related by Diocassus. Dr Cheyne mentions a man, aged 67, who had been, for several years, very liable to dyspnoea and anasarcous swelling of the legs. He was seized with apoplexy, and was saved by copious and repeated blood-letting. ‘‘ His constitution rallied after his illness,” says Dr Cheyne; “ the swelling of his legs subsided, and they have continued fine ever since.”f These cases certainly indicate a state of the system very diffe- rent from that which we understand by the term cachexia. Such affections, I believe, are usually treated upon the plan of merely evacuating the effused fluid. It forms an interesting subject of investigation, whether they would not admit of more active treatment. To this class of dropsical diseases is perhaps to be referred a dropsical affection of a dangerous and insidious character, which attacks women about the time of the cessation of the menses, and often affects those who were previously remarkable for health and vigour of constitution. It may begin as the period of ces- sation draws near, but its progress is more rapid after that change has taken place. The disease begins with nausea and oppression of the stomach, especially after meals. The appetite is in general not bad, but it is variable and capricious. I'he pulse is natural, and of good strength. There is, from an early period of the disease, anasarca of the legs, at first slight, but gradually increasing, and extending upwards on the thighs and the trunk of the body. The patient who, perhaps a short time before, was remarkable for activity, becomes sallow, listless, and inactive. As the disease advances, effusion takes place in the abdomen, and there is a considerable decay of flesh and strength. Sometimes there is difficulty of breathing, with symptoms of ef- fusion in the thorax. The complaint may go on for several months. Diuretics, purgatives, and tonics, may palliate parti- cular symptoms, and retard its progress, but it frequently baffles every mode of treatment. It is apt to terminate suddenly and unexpectedly, by slight delirium, succeeded by coma. On dis- section, effusion is found in all the cavities, but no disejise can be detected in any of the viscera. This dangerous and unma- nageable disease seems to have been more attended to by conti- * HofiVnannI Medicina Rationalis, (de Hydrope.) 'f Cheyne on Comatose Diseases.